title: Orange interventions for symptoms associated with dimethyl sulfoxide during stem cell reinfusions: a feasibility study.
abstract: BACKGROUND
  For over 2 decades, oncology nurses at a regional comprehensive cancer center offered sliced oranges to patients during the reinfusion of autologous hematopoietic progenitor cells (HPCs) to relieve symptoms associated with the preservative dimethyl sulfoxide (DMSO).
  
  
  OBJECTIVE
  This randomized pilot study examined feasibility and efficacy of sliced orange intervention (OI), orange aromatherapy intervention (OAI), or deep breathing (control) to address unpleasant adverse effects during HPC infusion.
  
  
  METHODS
  Orange intervention sniffed or tasted a quartered orange, OAI sniffed orange aromatherapy, and control took deep breaths. Perceived "symptom intensity" for tickle/cough urge, nausea, retching, and perceived "relief" were measured on 0- to 10-point numerical scales.
  
  
  RESULTS
  Sixty of 72 eligible patients consented to participate and were randomized to OI (n = 19), OAI (n = 23), or control (n = 18). Study personnel successfully administered study procedures. Over the course of 2 bags of cells infused, the OI group reported significantly greater relief with the intervention (P = .032). Among participants less than 90 kg, OI group reported significantly lower symptom intensity (P = .012).
  
  
  CONCLUSIONS
  Results suggest a feasible protocol and potential efficacy of sliced oranges for treating symptoms associated with DMSO-preserved stem cells. Study procedures provide a tested protocol for future studies. Follow-up study is warranted to confirm these findings and evaluate other treatment options.
  
  
  CONCLUSIONS
  Oranges offer a simple, noninvasive intervention for relieving symptoms associated with DMSO preservative during autologous HPC infusion.
authors.affiliation: School of Nursing, University of Portland, Oregon 97203, USA. potter@up.edu
authors.forename: Pamela
authors.initials: P
authors.lastname: Potter
authors.forename: Seth
authors.initials: S
authors.lastname: Eisenberg
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Cain
authors.forename: Donna L
authors.initials: DL
authors.lastname: Berry
mesh_terms: D000328:Adult; D019341:Aromatherapy / Q000379:methods* / Q000451:nursing; D032084:Citrus sinensis; D004121:Dimethyl Sulfoxide / Q000009:adverse effects*; D005240:Feasibility Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000451:nursing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D015404:Nursing Methodology Research; D009859:Oncology Nursing / Q000379:methods; D010865:Pilot Projects; D014182:Transplantation, Autologous; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D004121:Dimethyl Sulfoxide